Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 28;54(3):133-139.
doi: 10.4274/tjo.galenos.2024.02697. Epub 2024 Jun 5.

The Effect of Conjunctiva-Müller Muscle Resection on Tear Oxidative Stress Levels in Patients with Blepharoptosis

Seda Sert  1 , Ceyhun Arıcı  2 , Burak Mergen  3 , Özlem Balcı Ekmekçi  4
Affiliations

The Effect of Conjunctiva-Müller Muscle Resection on Tear Oxidative Stress Levels in Patients with Blepharoptosis

Seda Sert et al. Turk J Ophthalmol. .

Abstract
in English, Turkish

Objectives: To examine changes in tear oxidative stress levels and tear film functions in patients with blepharoptosis and dermatochalasis following conjunctiva-Müller muscle resection (CMMR) and blepharoplasty surgeries.

Materials and methods: This prospective study included 32 healthy controls and 62 patients with blepharoptosis or dermatochalasis. CMMR surgery was performed in 20 eyes and upper blepharoplasty was performed in 42 eyes. Tear oxidative stress markers (8-hydroxy-2’-deoxyguanosine [8-OHdG] and 4-hydroxy-2-nonenal [4-HNE]) were quantified by enzyme-linked immunosorbent assay and tear film functions were evaluated preoperatively and at 1 and 6 months postoperatively. The same assessments were performed in the control group at the same time points.

Results: Preoperative tear 8-OHdG and 4-HNE levels were lower in healthy controls (52.8±13.5 ng/mL and 27.8±6.4 ng/mL, respectively) compared to patients with dermatochalasis (86.1±37.2 ng/mL and 29.8±11.1 ng/mL, respectively) and blepharoptosis (90.4±39.3 ng/mL and 43.1±4.2 ng/mL, respectively) (p<0.001). 8-OHdG levels were increased at 1 month after CMMR, while both markers were decreased 1 month postoperatively in the blepharoplasty group (p=0.034). Schirmer 1 and OSDI scores did not change throughout the visits in both patient groups, but a temporary decrease in tear break-up time (TBUT) was observed after CMMR (p=0.017).

Conclusion: Dermatochalasis and blepharoptosis were associated with higher tear oxidative stress levels. CMMR surgery caused a temporary decrease in TBUT scores and an increase in oxidative stress in the first postoperative month.

Amaç: Blefaroptoz ve dermatoşalazisli hastalarda konjonktiva-Müller kas rezeksiyonu (KMKR) ve blefaroplasti ameliyatları sonrası gözyaşı oksidatif stres düzeyleri ve gözyaşı filmi fonksiyonlarındaki değişikliklerin incelenmesi.

Gereç ve Yöntem: Bu prospektif çalışmaya 32 sağlıklı kontrol ve blefaroptoz veya dermatoşalazisli 62 hasta dahil edildi. 20 göze KMKR ameliyatı, 42 göze üst blefaroplasti ameliyatı uygulandı. Ameliyat öncesi ve ameliyat sonrası 1. ve 6. aylarda, enzim bağlantılı immünosorbent testi ile gözyaşı oksidatif stres belirteçlerinin (8-2’-deoksiguanozin [8-OHdG] ve 4-hidroksi-2-nonenalhidroksi [4-HNE]) düzeyleri belirlendi ve gözyaşı filmi fonksiyonları değerlendirildi. Kontrol grubunda da aynı değerlendirmeler eş zamanlı yapıldı.

Bulgular: Ameliyat öncesi gözyaşı 8-OHdG ve 4-HNE düzeyleri sağlıklı kontrollerde (sırasıyla 52,8±13,5 ng/mL; 27,8±6,4 ng/mL) dermatoşalazis (sırasıyla 86,1±37,2 ng/mL; 29,8±11,1 ng/mL) ve blefaroptoz (sırasıyla 90,4±39,3 ng/mL; 43,1±4,2 ng/mL) hastalarına kıyasla daha düşük bulundu (p<0,001). KMKR’den 1 ay sonra gözyaşı 8-OHdG düzeyleri arttı, blefaroplastiden 1 ay sonra her iki belirteç düzeyinde de düşüş görüldü (p=0,034). Her iki hasta grubunda da Schirmer 1 ve oküler yüzey hastalık indeksi skorları vizitler arasında değişiklik göstermezken, KMKR sonrasında gözyaşı kırılma zamanında (GKZ) geçici bir düşüş görüldü (p=0,017).

Sonuç: Dermatoşalazis ve blefaropitoz daha yüksek gözyaşı oksidatif stres düzeyleri ile ilişkiliydi. KMKR, 1. ayda GKZ skorlarında geçici düşüşe ve oksidatif streste artışa neden oldu.

Keywords: Blepharoptosis; blepharoplasty; dermatochalasis; oxidative stress; tear film.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Baseline mean tear 8-hydroxy-2’-deoxyguanosine (8-OHdG) and 4-hydroxy-2-nonenal (4-HNE) levels in the three groups
Figure 2
Figure 2
Changes in mean tear 8-hydroxy-2’-deoxyguanosine (8-OHdG) concentration between consecutive visits in the three groups
Figure 3
Figure 3
Changes in mean tear 4-hydroxy-2-nonenal (4-HNE) concentration between consecutive visits in the three groups
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Nalcı H, Hoşal MB, Gündüz ÖU. Effects of Upper Eyelid Blepharoplasty on Contrast Sensitivity in Dermatochalasis Patients. Turk J Ophthalmol. 2020;50:151–155. - PMC - PubMed
    1. Bacharach J, Lee WW, Harrison AR, Freddo TF. A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options. Eye (Lond) 2021;35:2468–2481. - PMC - PubMed
    1. Putterman AM. A clamp for strengthening Müller’s muscle in the treatment of ptosis. Modification, theory, and clamp for the Fasanella-Servat ptosis operation. Arch Ophthalmol. 1972;87:665–667. - PubMed
    1. Zauberman NA, Koval T, Kinori M, Matani A, Rosner M, Ben-Simon GJ. Müller’s muscle-conjunctival resection for upper eyelid ptosis: correlation between amount of resected tissue and outcome. Br J Ophthalmol. 2013;97:408–411. - PubMed
    1. Peter NM, Khooshabeh R. Open-sky isolated subtotal Muller’s muscle resection for ptosis surgery: a review of over 300 cases and assessment of long-term outcome. Eye (Lond) 2013;27:519–524. - PMC - PubMed

MeSH terms

LinkOut - more resources